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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009141 <br /> DATE RECEIVED by EHD: Apri106,2012 APPL#: PA-1200049 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2622 <br /> SUBDIV ISDN-MINOR(MS) <br /> COMPLETE&SUBMIT BY: A-p/1./L Z7<h 20/z. <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 5772 S VAN ALLEN RD, STOCKTON APN: 18335011 12 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage disposal, water <br /> supplies, etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population <br /> density, location of house, wind direction, etc.... <br /> Public Water: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS- <br /> ii" <br /> ' /(yam/ �/ CLh�'�FiclfE� tel-IZESdI�PI�G�C �L"�t= S.��ZtG SY57c�7 �i �07 /�C�r <br /> - �:37� LB�GS�s�--nyrF1.�-� � i�.^• /�is�Ejf�L�1` <br /> Ale <br /> A-) 14!/'L 6AA5-71L ' iN e7A+D sl4s 1715K Ib A RPi Ju?r!!2� <br /> I recommend: Approval Denial Continuance Inspector: <br /> Supervisor/Lead/Lead Senior COMMENTS, <br /> Signature <br /> a v <br /> , <br /> LJ Ny-A/p <br /> © L I 0 <br /> 0 <br /> SUPERVISOR/LEAD SENIOR Approval: _ Dat <br /> OA It Check Off List Pi oorread Report? G <br /> Correct LAND USB4 <br /> Correct(:ONDITION(S)? Logged in LAND USE Book? <br /> 2H 06 06 Report#7201 <br /> ,A pri 106. '01 <br />